Our Nation Is Not Healthy

There's more than a little delicious irony in the fact that the shebeen was late in opening on Tuesday because I had to go in for regular medical treatment for a chronic condition handed down to me by my Celtic-Norman ancestors. That gave me a good chance to look over the malodorous sheaf of shredder-fodder produced by the House of Representatives as an alternative to the Affordable Care Act. This isn't a plan. This is not a burlesque of a plan. This is not even a ghost of a plan. And everybody hates it.

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(I also was late in opening because a water main broke and pretty much shut down the whole Fenway neighborhood to vehicular traffic of any kind. Infrastructure next! And what a joy that's likely to be.)

And here is something else that it is not. It is not TrumpCare. It is RepubliCare. The bill that dropped like a dead fish in a sanctuary late Monday evening is the culmination of nearly 25 years of Republican policy thinking since Bill Clinton put health care reform at the top of the agenda in the 1992 campaign. All of the greatest hits are in there, and they're all just as cruel and stupid and unworkable as they ever were. This is why it's RepubliCare:

Health Savings Accounts! Start saving when you're three and if you spend the rest of your life living atop a flagpole, you might be able to afford half-a-round of chemo when you're 60.

Health Insurance Across State Lines! Let's apply the always consumer-friendly business model of the credit card industry to something people literally need to stay alive.

Block Grants! Also known as the Scott Walker Cronies Supplemental Income Act of 2017.

Getty ImagesMark Wilson

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These are not ideas that came in with the current president*. (Quite honestly, I don't think he has the vaguest idea what any of them are.) They are the treasured preciouses of two generations of conservative policy intellectuals. (By which I mean the guys that Jonathan Chait cites in his nifty evisceration of the new bill. Sorry, guys. Back to the mink-lined drawing boards of the conservative think tanks.) And these ideas lay exposed now as the charlatan's toolbox that they've always been.

This is why it's RepubliCare. Because it was nurtured along by Speaker Paul Ryan, the zombie-eyed granny-starver from the state of Wisconsin. Every couple of years, you may recall Ryan would come up with another "budget" that caused actual economists to dissolve into helpless laughter and caused his fellow Republicans to hide behind the drapes until he passed. Now, we have his health care plan, presented to the Congress without having been scored, possibly because everyone in the CBO who looked at it needed oxygen immediately.

It is not TrumpCare. It is RepubliCare.

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Ryan's tell-tale fingerprints are all over this mess. The tax break for CEOs. The preposterous seven pages spent to make sure that lottery winners are not somehow gaming the system, a scandal that heretofore had escaped my attention. (Knowing Ryan, however, I am fairly sure that these safeguards do not apply to winners in the Lucky Sperm Lottery.) Paul Ryan is a guy whose family got rich on government construction contracts and who got all the way through high school and college on Social Security survivor benefits—you're welcome, dickhead—and who yet can concoct a world view by which a government mandate is tyranny but a private sector mandate is the essence of political liberty.

You have noticed, of course, that, if someone goes without insurance for more than 63 days, which is not out of the realm of probability given the other features of this catastrophic lemon, that person can have his rates jacked up 30 percent. Now because you and I are not the coddled scions of the conservative movement the way Paul Ryan is, you and I know goddamn good and well what's going to happen here.

Getty ImagesChip Somodevilla

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Somebody loses their job and, thus, their health insurance. They remain unemployed for 60 days. On the 61st day, they get another job and fill out all the paper work for new insurance. How hard do you think it will be for some insurance company tyro to "lose" the paperwork for two days in order to get that sweet premium increase? Hell, they give people training in how to do this kind of thing. If you liked all the stories about elderly widows getting robo-signed out of their homes, you're going to love all the stories about people getting paper-whipped out of their health care. Once again, as always has been the case with his "budgets," Paul Ryan has developed a finely tuned machine, as long as nobody complicates it with, you know, math, money, or human beings.

"We are getting rid of the individual mandate. We are getting rid of those things that people said that they don't want. And, you know what? Americans have choices. And they've got to make a choice. So maybe, rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on, maybe they should invest that in health care. They've got to make those decisions themselves."

Apparently, cellphones are the new Cadillacs and big, black bucks buying steaks. I do disagree with the headline. This argument is not "revived" by what Chaffetz said. It never went away. It is the foundation of all conservative social policy since the New Deal kicked over the apple cart. It gussies itself up in different ways, and it occasionally chooses new victims to wound, but it never goes away. It's all they have, as this new bill demonstrates.

Paul Ryan has developed a finely tuned machine, as long as nobody complicates it with math, money, or human beings.

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Look beyond Chaffetz, for example, to this dipwad congresscritter from Kansas, Roger Marshall, who looked into the gospels and found them to be something akin to the old Poor Laws. From Bustle:

"Just like Jesus said, 'The poor will always be with us,'" said Marshall, a former obstetrician, in an interview with Stat on Friday. "There is a group of people that just don't want health care and aren't going to take care of themselves… Just like homeless people ... I think just morally, spiritually, socially, [some people] just don't want health care ... The Medicaid population, which is a free credit card [sic], as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I'm not judging, I'm just saying socially that's where they are. So there's a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought [into] the ER."

Consider also that the only viable political opposition to this bill within the Republican Party does not come from frightened senators, or from the disappointed alleged wonks of the conservative bright-boy set. It comes from the Heritage Foundation, and the Club For Growth, and the House Freedom Caucus, and from the konztitooshunal skolars in the Senate, including Mike Lee of Utah, Tailgunner Ted Cruz of Texas, and Rand Paul of Kentucky.

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In other words, the only substantial enemies of any political power whatsoever that this bill has within the party that's proposing it comes from people who think it's…too…damn…generous. Think about that for a moment. Think about what it must be like to get up in the morning and think that this concocted dog's breakfast gives too much of a helping hand to your fellow citizens. How does your heart not turn black and leap out of your chest at the very thought of that? How do all your mirrors not crack? How does your blood not run even colder than it usually does?

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